<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket="http://wicket.apache.org">
<wicket:panel>
    <h1 class="pageTitle">Contacten</h1>

    <div class="row-fluid">
        <div class="span9">
            <div wicket:id="bvoFilterContainer"></div>
        </div>
        <div class="span3">
            <div class="passport">
                <wicket:container wicket:id="passpoort"></wicket:container>
            </div>
        </div>
    </div>
    <div class="row-fluid">
        <div class="span9">
            <form wicket:id="form">
                <fieldset class="">
                    <div class="form-horizontal">
                        <div class="control-group">
                            <label class="control-label span12">Opmerking</label>
                            <div class="controls" style="margin-left: 0;">
                                <textarea class="textarea-full-width" id="opmerkingen" wicket:id="opmerking"></textarea>
                            </div>
                        </div>

                        <div class="control-group">
                            <div class="controls" style="margin-left: 0;" wicket:id="vervolgacties">
                                <div wicket:id="vervolgactiesGen">
                                    <strong>Algemeen</strong>
                                    <label class="checkbox" wicket:id="vervolgactie">
                                        <input type="checkbox" wicket:id="checkbox">
                                        <wicket:container wicket:id="label"/>
                                    </label>
                                </div>
                                <div wicket:id="vervolgactiesCervix">
                                    <strong>Baarmoederhalskanker</strong>
                                    <label class="checkbox" wicket:id="vervolgactie">
                                        <input type="checkbox" wicket:id="checkbox">
                                        <wicket:container wicket:id="label"/>
                                    </label>
                                </div>
                                <div wicket:id="vervolgactiesMamma">
                                    <strong>Borstkanker</strong>
                                    <label class="checkbox" wicket:id="vervolgactie">
                                        <input type="checkbox" wicket:id="checkbox">
                                        <wicket:container wicket:id="label"/>
                                    </label>
                                </div>
                                <div wicket:id="vervolgactiesColon">
                                    <strong>Darmkanker</strong>
                                    <label class="checkbox" wicket:id="vervolgactie">
                                        <input type="checkbox" wicket:id="checkbox">
                                        <wicket:container wicket:id="label"/>
                                    </label>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div wicket:id="actiePanels" class="vervolgstap"></div>
                </fieldset>

                <div class="buttons">
                    <a href="javascript:void(0);" class="btn btn-primary pull-right" wicket:id="afronden">Contact afronden</a>
                </div>
            </form>
            <div class="clearfix"></div>
            <h2>Historie contacten</h2>

            <div class="historie-contacten" wicket:id="contacten"></div>
        </div>
    </div>

    <div wicket:id="dialog"></div>
</wicket:panel>
</html>
